Blogging a "Healthy Mind"

As I work with clients there are times when certain psychological truths seem to jump out at me. They may involve things I have understood previously and am seeing in a renewed light, or things I am coming to understand for the first time. In any case, what follows are some gleanings of these thoughts from my therapy room. Hopefully, you will find something helpful and of interest to you among them.

The "Death Layer" in Gestalt Therapy - February 4, 2008

I am presently involved in a training course on Gestalt therapy at the Pennsylvania Gestalt Center. To do this I drive up two or three times per month for training events. One idea that has caught my attention is what Gestalt therapy calls the "death layer" of personality.

Gestalt therapy conceptualizes our personalities as having several different layers. The most superficial layer is a social layer consisting of how we handle our most simple of human interactions: "Hi, how's your day going? Can you believe this weather?"

The second layer consists of the roles that we adopt to cope with most of our day to day relationships. This could include our role as a "good employee", "faithful friend", or in terms we use for alcoholic and dysfunctional families, "hero", "mascot", "lost child", etc.

The third layer is made up of our fears, addictions, and other reactions to traumatic experiences in our lives. It's at this place where we experience significant impasses in our ability to deal with life effectively.

The fourth layer is deeper yet and is called the "death layer." It has nothing to do with real death, necessarily. Rather, it deals with the material that feels more like psychological death. This is where we hold feelings like, "I'm unloveable", "I'm unworthy", "I'm so broken that I absolutely cannot let you know about it." These are the beliefs that we hold about ourself that are our core fears...the beliefs that cause us to hide in loneliness and fear.

The fifth layer is more positive, it is the life force that enables us to eventually break through the content of the death material (usually with help) to hope, an authentic connection with our real and positive self, and a sense of integration and joy in living.

In reading the above material, which I have paraphrased a bit, it has become clear to me that the material that scares us most holds the most hope for healing. In talking with clients about this recently I find myself referring to the Wizard of Oz, where the big, scary, booming voice of the Wizard turned out to be a fake. There was no scary wizard. In the same way, I believe our inner voice that says we're unloveable or unable to connect with others is fake also. We are not so bad as we think...and when we actually do take a look at ourselves in the light of the reactions of other healthy people to whom we expose ourselves, we will find that we are loveable after all. Of course, the journey to facing that voice can be scary indeed, and not everyone is willing to go on it. We need to be somewhat like Harry Potter, willing to face the "name that must not be named." At times it can feel that even to utter our fears out loud may make them come true.

Gestalt therapy, when practiced well, has the possibility of bringing our fears out into the open where they can be seen by supportive others. In this environment, much can happen to encourage healing at the deepest levels. It is truly possible for joy to occur. Rather than going to therapy to simply survive, one can thrive in meaning, self acceptance, and generosity in ones life.

One last comment: sharing our concerns as described here with those who avoid introspective thinking can result in an unhappy conversation. People may tell you that, "You shouldn't feel that way." It is tempting to apply a "quick fix" to someone who is honest about struggles. Rather, share yourself with those who seem to be insightful and kind. Better yet, do some of this in a therapy group where the therapist can help you gently and effectively face your fears and discover their ultimate impotence. Tears may flow, but they will be tears of relief and joy rather than despair.

And yes, if you're reading this, then I mean you, not everyone else but you. Your death layer is not invincible, though it may feel that way. Your life is not uniquely impossible :)

The Role of Attachment - November 17, 2007

I recently attended the annual conference for the Society for the Advancement of Sexual Health, an organization dedicated to helping those who suffer from out of control sexual behavior. In recent years more and more workshops about attachment have been presented as a fundamental concept in the treatment of sexual addiction. While I was there it became clear to me that attachment disorders are central to problems often addressed in the therapy room, not just for sex addiction, but for many other problems also. I wrote my thoughts down in an outline, which I share with you here.

The Nature of Sex Addiction - November 15, 2007

Sex addiction has been classified as many things...an addiction like alcoholism, an intimacy disorder, and an attachment disorder, just to name a few. In my opinion, they're all correct. However, I have also noticed that sex addiction seems to be about the need for attention.

According to Pat Carnes' research as reported in Don't Call it Love (see recommended books) sex addicts tend to come from homes that are low in warmth but high in demands for rigidly good behavior. These are going to be homes where little warm attention is provided. An inner hunger develops, and sex is the nearest pseudo-intimacy that is easily available, whether in fantasy or in person.

When recovering from sexual addiction, ask yourself if you are getting enough attention. This means surveying your social network and asking yourself if you have adequate personal communication with friends and family. If not, expand and deepen your communication with others. We all need healthy attention. Without it we will tend to try to get unhealthy attention of some sort. Whether it's writing graffiti on a wall as a teen or paying excessive attention to our body as adults to be sexually alluring, we will all act in one way or another to get attention. And if we don't, if we become socially "anorexic", then we embrace even a greater unhappiness.

Reaching Out Far Enough: the Gestalt Cycle of

Hunger, Reaching Out, Satiation, and Rest

November 10, 2007

Gestalt therapy teaches that we all go through a natural cycle of becoming aware when we're hungry for something, and then reaching out for what we need. If we are successful we become satisfied, the hunger goes away, and we rest relative to that desire and turn to other things until the hunger returns. This cycle goes on and on for many things, including food, receiving nurture, providing nurture, excitement, calmness, etc.

However, several things can go wrong at different points in this cycle:

Awareness

You may not being able to identify your needs (lack of knowledge/ misunderstandings about ourselves and others/misbeliefs)
Denying your needs (being fearful of them, not wanting to hear about them)

Reaching out

Feeling it is useless to reach out, or that you'll lose the fulfillment of your need if you get it
Having a fear of traumatic outcome for reaching out
No skills or practice - not knowing how to reach out or having enough practice doing so

Taking In

Feeling weak or "pathetic" for having your needs
Feeling that somehow you are not allowed to have your needs met
Being unable to take in, celebrate, and enjoy when the need is met

Rest

Not letting yourself relax; feeling like you must keep moving
Inability to rest, reflect, & digest

This is a lot of information to take in, and it may be a bit confusing. However, what I really want to say in these few paragraphs is that I have become gradually aware how often we don't really reach out far enough to get our relational (or other) needs met, if we reach out at all. How extensively do we reach out to family and friends? What groups have we joined, or activities have we explored? To be lonely in a city of thousands of people probably doesn't need to happen if we work on our self esteem, polish up our social skills, and extend ourselves to others. Alcoholics have found much fellowship and meaning in their lives through relationships with other recovering alcoholics at Alcoholics Anonymous--even when their lives are a mess. Far too often we don't reach out very far. We hide and are ashamed to reveal ourselves to others.

Ernest Kurtz & Katherine Ketcham in “The Spirituality of Imperfection” (see recommended books) write:

The spirituality of imperfection suggests that our weakness
makes us alike; it is our strengths that make us different.

They go on to report the following humorous anecdote:

A man was looking for a good church to attend and he
happened to enter one in which the congregation and the
preacher were reading from their prayer book. They were
saying, “We have left undone those things which we ought to
have done, and we have done those things which we ought not
to have done.” The man dropped into a seat and sighed with
relief as he said to himself, “Thank goodness, I’ve found my
crowd at last.”

They eventually close their wonderful book with this thought:

If we can accept the reality of our imperfection, the fact that we are put together funny, that we are, by our very nature, limited
and thus do not have absolute control over our lives, we are
taking the tentative steps that are all that we can take on the
pilgrimage that is spirituality.

To satisfy our hunger for others in our lives we're going to have to reach out. Sometimes we're going to have to reach WAY out...way past what's comfortable for us. This often includes being more vulnerable than we want to be. But it's possible. and it can work. And it's worth it.

This can mean volunteering, joining clubs, starting a book reading group, attending a church or social group, or being part of a support group. I have been in one small group or another for most of my adult life. I met with one group of friends for seven years, and we read and discussed books about personal growth. We did a variety of activities together to enhance our lives and make them increasingly meaningful. I just recently started a personal growth group in which we will use Gestalt role play techniques to help us get perspective and gain forward movement in areas of our lives that are unsatisfying or puzzling. This is a personal, not a professional, activity for me, and I am an equal member in the group. To find enough members I had to send emails to my professional and personal friends, advertise on the therapeutic section of Craigslist, and send an email to the listserv for my neighborhood association. It worked. We have 11 of us in the group...and we're loving it.

It can work for you also. But you have to reach far enough...and you CAN do it. Expanding yourself socially, making your mistakes honestly as you do it, but learning and continuing to reach out is good for your mental health. It is also a happy way to live.

David C. Bissette, Psy.D. Alexandria, VA 703-705-6161